Clinical and Epidemiological Profile of Progressive Supranuclear Palsy in a Colombian Referral Center: A Retrospective Cohort Study
Marcela Henao-Pérez, Diana Carolina López-Medina, Alejandra Arboleda-Ramírez, Zahian Barroso-Barrera, Juan Pablo Londoño-AristizábalBackground
Progressive supranuclear palsy (PSP) is a rare 4‐repeat tauopathy characterized by marked clinical heterogeneity and frequent diagnostic delay. Epidemiological and phenotypic data from Latin America remain limited. This study aimed to describe the clinical and epidemiological characteristics of PSP in a Colombian referral center and to compare findings by sex and phenotype.
Methods
We retrospectively reviewed PSP cases evaluated at a Colombian neurological referral center from 2013 to 2023. Demographic, clinical, neuroimaging, diagnostic, and treatment‐related variables were extracted from medical records. PSP phenotypes were retrospectively classified and grouped using clinical information from medical records. Period prevalence was estimated using the adult population of Antioquia as the denominator.
Results
Among 152 patients, 53.9% were male. Crude period prevalence was 1.8 per 100,000 adults, peaking at 75–84 years. Women were older than men at evaluation, whereas age at symptom onset was similar between sexes. Mean diagnostic delay was approximately 3.5 years. Postural instability was the most frequent presenting symptom. PSP‐Richardson syndrome and PSP‐parkinsonism were the most common phenotypes. MRI was the most frequently requested imaging study, and midbrain atrophy was the most common abnormality. Levodopa/carbidopa was the most frequently prescribed medication, with documented initial response in only a subset of treated patients.
Conclusions
PSP in this Colombian cohort predominantly affected older adults and was characterized by substantial diagnostic delay, marked phenotypic heterogeneity, and predominantly symptomatic treatment. These findings expand the limited Latin American literature and underscore the need for earlier recognition of both typical and atypical PSP presentations.